Riley Children’s Health anticipates an ongoing massive response will be required by healthcare providers on all fronts. Our hospitals, ERs, urgent cares and offices will be strained to treat the sickest patients and also provide care for patients outside of the COVID-19 crisis.

Primary care providers will continue to play a crucial role in this pandemic response. For us to keep up with demand, and save lives, we will depend in large part on primary care providers having capacity and resources to treat less acute patients throughout our communities. Thank you for your partnership.

Updates

June 4

Riley pediatric inpatient unit reopens at North, post-COVID As Riley Children’s Health operations continue to shift to the “next normal” in a COVID-19 world, the Riley inpatient unit at IU Health North Hospital has resumed admitting med-surg and ICU pediatric patients this week.

When COVID-19 first surged in the local community earlier this year, Riley temporarily centralized pediatric admissions in Indianapolis to Riley Hospital for Children to support the need of pediatric patients in a controlled environment while allowing IU Health hospitals to meet the pressing needs of adult patients.

Riley doctors, nurses and patient care support teams are staffing the North unit as they did before COVID surge began.

Admissions at North can be made, as they always have, by calling the Transfer Center (877.447.4539) or through the Emergency Departments.

Six pediatric beds at North continue to serve adult patients. At IU Health West hospital, two pediatric beds continue to be dedicated to adult patient needs. Returning the remaining North and West beds to pediatric service will be re-evaluated later this summer.

May 13

Our team at Riley Children’s Health is committed to delivering the highest level of care at all times. Based on current COVID-19 trends in our state and our adult hospital setting, the NICU on the 3rd floor at IU Health Methodist Hospital is now reopened and admitting patients.

In order to protect the safety of our patients, families, and team members we have implemented the following safety guidelines and procedures:

• Health screening of parents will continue to occur at main lobby information desk at Methodist
• In accordance with Riley visitation guidelines, only one parent at the bedside
• Parents will be required to wear a mask while visiting in the NICU
• Added plexiglass barriers and defined spaced around beds to ensure social distancing
• Patients (babies) of COVID-19 positive or PUI mothers that require NICU care will be stabilized at Methodist and then transferred out to an appropriate level nursery where single isolation rooms are available. Our team remains committed to communicating these possible options with those families and informing referring providers.

Any current patients previously transferred from Methodist and still hospitalized at Riley Hospital for Children will be discharged appropriately from there.

With these safety guidelines in place, we feel confident in having our patients housed at Methodist and, although not anticipated to have any further changes, we will continue to monitor COVID and react as needed if the situation were to change.

Previous Updates

We are making temporary adjustments to pediatric units at IU Health North and IU Health West hospitals:

• Effective March 17, all pediatric admissions will be centralized to Riley Hospital for Children at IU Health in Indianapolis, and inpatient pediatric rooms at both hospitals will transition to accommodate the growing needs of the adult population. This allows us to support the needs of pediatric patients in a controlled environment, as well as meet the operational needs of IU Health North and IU Health West.
• The NICU at IU Health North and the newborn nurseries at both locations are not impacted by this decision.

Frequently Asked Questions

Q: How can I best prepare my clinic?

• Immediately configure your clinics to see low acuity respiratory patients.
  • Divide your flow so that patients with and without respiratory symptoms are seen in separate spaces.
  • Consider a separate check-in process – one for those with respiratory symptoms and one for those with other symptoms, such as a front door versus a back door entrance.
  • Consider checking symptomatic kids in their cars and/or asking them to remain in cars until a room is ready for them.
  • Be creative in this crisis situation to minimize in-person patient visits for suspected COVID-19; use phones, video apps, etc. to see patients and help limit the spread of the virus
    • Due to the need for an informed and coordinated public health response, U.S. Secretary of Health and Human Services (HHS) Alex Azar has declared a limited waiver of certain provisions of the HIPAA Privacy Rule.
  • Do not automatically redirect patients with respiratory symptoms to urgent care or emergency departments. Manage as much patient care as possible without sending patients to an urgent care or the ED.

• If you experience an increased demand for respiratory visits, consider canceling planned non-urgent patient visits, such as well-child visits. Limit well-child appointments to immunizations only, to free up appointments for respiratory patients, and keep patients at home.
• Isolate non-emergent respiratory patients with quarantine at home.
• Consider coordinating with other clinics to become a larger outpatient system for triaging and managing patients.
• Focus now on procuring the personal protective equipment (PPE) needed by your staff, including gloves, masks, eye shields or goggles (not eyeglasses), and gowns.
• Stay up-to-date on the guidance on evaluating and reporting Persons Under Investigation (PUI) from the Centers for Disease Control and Prevention (CDC).

We continue to receive many calls from the general public about COVID-19. To avoid burdening hospital phone lines and diverting staff from COVID-19 preparations, we are asking our primary care partners in the community to help us direct these inquiries to the appropriate public health authorities and other trustworthy information sources, including:

• Our Riley Children’s Health COVID-19 Patient Resource Page
• The Indiana State Department of Health
• The Centers for Disease Control and Prevention (CDC)

Q: When should PCPs send patients to the Riley at IU Health Emergency Department? When should PCPs not send patients to Riley at IU Health?

• If you suspect your patient has COVID-19, the family should utilize the IU Health Virtual Visits app for an initial screening and support on what to do next. Staffed 24/7 with IU Health physicians, advance practice providers and registered nurses, the clinic will screen patients from home, potentially eliminating the need to visit physician offices, urgent cares or emergency departments.
• For other emergent needs, a pediatric hospitalist is onsite at IU Health North to support the Emergency Department for the foreseeable future. If you know or suspect your patient may need admission, you may direct them to the Riley Hospital for Children at IU Health Emergency Department.
• IMACS (consults) and the Transfer Center (transfers) continue to be available:
  • IMACS (800.622.4989)
  • Transfer Center (877.247.1177)

Q: How will I know if you are treating my patient for COVID-19?

If your patient is seen at Riley at IU Health for suspected COVID-19 (or any other condition), you will receive our standard follow-up communications regarding ER summary, admission, discharge, etc.

Q: If one of my patients is an inpatient at Riley at IU Health, what can they expect?

The clinical staff and providers at Riley at IU Health are trained on the identification, isolation and treatment of COVID-19 and other infectious diseases. At this point in time:

• If an inpatient does not have cold or flu-like symptoms, they will continue to receive care without change.
• If the primary caregiver has symptoms of fever or cough, they should not visit.
• Effective March 15, only one designated visitor (parent or guardian) is allowed per patient at Riley at IU Health. This allows us to limit exposure to our hospitalized patients. Exceptions will be considered for end-of-life situations, and in the NICU where two designated visitors are allowed, but must visit individually. We are working hard to utilize all of our extensive resources as a comprehensive children’s hospital to support our patients and families during this stressful time through our robust online resource center.

The situation with COVID-19 is evolving rapidly and procedures for patient care will change as necessary to best protect patients, their families and staff.

Q: Are surgeries and specialty care appointments continuing?

Starting March 16, we began rescheduling all elective, non-urgent surgeries and procedures so that our care teams can be available for those patients who have immediate needs.

Now, most primary care and specialty follow-up visits are conducted as a virtual or telephone visit. All urgent/critical patients and referrals are reviewed on a case-by-case basis to determine if an in-person appointment is necessary. In the event they are not urgent, and the patient prefers to be seen in-person, the appointments have been rescheduled. Patients are encouraged to call their specialist if their symptoms worsen prior to their appointment.

We continue to accept referrals for new patients. Referrals can be made online or by faxing or calling the applicable department.

Q: Do you have resources or patient support materials I can share with my patients?

To help answer questions from patients and families, we’ve created an online resource center. There, you can find helpful information from our expert physicians about steps you can take to prevent the spread of the virus and how to a get a free screening if you suspect you have it.

We understand that these adjustments may have a major impact on the lives of our patients and families, and deeply appreciate your patience and understanding while our community is going through this public health emergency. As conditions are rapidly evolving, we may need to change patient care to protect patients, family and staff. We will keep you informed on those changes as quickly as we are able.